PubMed · 112346
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S M Jimenez, L C Jones, R G Jungman. Prenatal classes for repeat parents: a distinct need.. https://doi.org/10.1097/00005721-197909000-00014
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The effects of birth order, presentation and method of delivery on neonatal mortality and neurodevelopmental outcome in nondiscordant low birthweight ( < 2500 g) twin gestations were evaluated. Sixty-four sets of twins were included in the study; 29 sets were in vertex/vertex presentation (Group I), 25 sets in vertex/breech (Group II) and in 10 pregnancies the first twin was nonvertex (Group III). The rate of favorable neonatal outcome (survival and normal neurodevelopmental outcome after a 2-year follow-up) was lower in pregnancies in which at least one twin was in nonvertex presentation (50/70 vs. 52/58 P = 0.02). However, after adjustment by multiple logistic regression analysis for the effects of gestational age, birthweight, birth order and educational level of the mother, this difference was not statistically significant (odds ratio = 0.6; 95% confidence interval 0.44 to 5.9; P = 0.5). In pregnancies in which at least one of the twins was in nonvertex presentation, delivery by cesarean section did not affect the rate of favorable neonatal outcome (odds ratio = 1.8; 95% confidence interval 0.48 to 12.9; P = 0.8). The results of this study suggest that in low birthweight twin gestations, method of delivery in relation to fetal presentation has little or no effect on neonatal mortality and subsequent neonatal neurodevelopmental outcome.
The 4275 births to women of native ancestry that took place on the island of St Barthélemy, French West Indies between 1878 and 1970 were analyzed according to the sex of the child, the year of birth, maternal age, maternal parity, paternal age and the number of children the father already had to determine the effects of these variables on rates of perinatal death, death before age 1 and death before age 5. The year of birth, the number of children the father already had, and maternal parity influenced death before age 1 and death before age 5. The sex of the child also influenced the probability of dying in the first year of life but not the first 5 yr of life when the other variables were controlled. Perinatal deaths were influenced only by the sex of the child, but even this effect disappeared when the other variables were controlled.
Birth Order has been described as a variable with a complex relationship to child and adult outcomes. A review of the medical literature over the past 5 years identified 20 studies that investigated the relationship between Birth Order and a health outcome. Only one of the studies established a relationship between Birth Order and a health outcome: third and fourth-born children have a higher incidence of accidents that result in hospitalization. The other demonstrated relationships are each explained by intervening variables or methodological limitations. Although Birth Order is not a strongly independent explanatory factor in understanding health outcomes, it is an important marker variable. Statistically significant relationships between Birth Order and health outcomes yield insights into the ways a family influences an individual's health.